2004-2009年河南省克山病病情监测分析

目的 了解2004-2009年河南省克山病病情及发病趋势.方法 2004-2007年选河南省洛宁县故县乡、上戈乡为监测点,2008、2009年分别选灵宝市朱阳镇、卢氏县沙河乡为监测点.对监测点居民进行临床查体和心电图描记;对可疑克山病患者、可疑心脏增大者和心电图异常者拍摄胸部正位X线片,测量心胸比.采集监测点居民发样及其家中粮食(面粉)样品,用氢化物原子荧光光谱法进行含硒量检测.结果 2004-2009年河南省共检查4034人,检出慢型克山病21例、潜在型克山病病例75例,检出率分别为0.52%(21/4034)、1.86%(75/4034).共描记心电图4034份,心电图异常751例,异常率为18.62%;异常心电图以STT改变占24.63%(185/751)]、左心室高电压占18.11%(136/751)],左室肥厚占13.85%(104/751)]为主.采集粮食样品61份,粮硒平均为0.034 mg/kg;采集发硒样品30份,发硒中位数为0.285 mg/kg.结论 河南省克山病病情呈平稳低发态势,但病区异常心电图比率较高,应积极开展防治研究.

Statistical analysis of monitoring data regarding the state of Keshan disease in Henan province from 2004 to 2009

Objective To study the state and trends of Kesan disease in Henan province from 2004 to 2009. Methods Surveillance sites were selected: Guxian village of Luoning country from 2004 - 2007, Zuyang town of Lingbao city in 2008, and Shahe village of Lushi country in 2009. All residents of surveillance sites were examined by clinical and electrocardiogram, and suspected patients were inspected by chest X-ray to measure ardiothoracic ratio. Hair and wheat flour samples were collected and selenium levels were detected with hydride generation atomic fluorescence spectrometry. Results From 2004 to 2009, a total of 4034 people were examined.The numbers of chronic and latent KSD patients were 21 and 75 cases,respectively, and the incidence rates were 0.52%(21/4034) and 1.86%(75/4034), respectively . The number of abnormal electrocardiogram was 751 cases, and the incidence rate was 18.62%. The highest proportion of abnormal electrocardiogram was ST-T changes,accounting for 24.63%(185/751), followed by high-voltage, accounting for 18.11%(136/751), and left ventricular accounting for 13.85% (104/751). Sixty-one grain samples were collected and the wheat flour selenium level was averaged 0.034 mg/kg. Thirty hair samples were collected and the selenium median was 0.285 mg/kg. Conclusions The state of Keshan disease is in a steady state in Henna province, but higher rates of abnormal electrocardiogram is a serious problem and should be studied and prevented.